Editorials
24 February 2025
Vol. 4 No. 1 (2025)
Management of atrial fibrillation: a practical and useful synopsis of last guidelines
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
694
Views
0
Downloads
Authors
Atrial fibrillation (AF) is the most common arrhythmia and a disease of aging, as its prevalence increases in the elderly population, reaching approximately 10% in people aged 80 years and older. More than 66% of nearly 6,000 Italian AF patients included in a dedicated observational study were >75 years of age. AF is a strong independent risk factor for stroke due to thrombus formation in and embolization from the left atrial appendage. AF is associated with a fivefold increase in the risk of stroke, which tends to be more severe with higher mortality and disability than strokes in patients without AF. To reduce the risk of stroke or peripheral embolism, treatment with oral anticoagulants is recommended for most patients with AF.
Altmetrics
Downloads
Download data is not yet available.
Citations
1. Go AS, Hylek EM, Phillips KA, et al. Prevalence of diagnosed atrial fibrillation in adults - National implications for rhythm management and stroke prevention: the AnTicoagulation and Risk Factors in Atrial Fibrillation (ATRIA) study. JAMA 2001;285:2370-5. DOI: https://doi.org/10.1001/jama.285.18.2370
2. Poli D, Antonucci E, Ageno W, et al. Inappropriate underdosing of direct oral anticoagulants in atrial fibrillation patients: results from the START2-AF registry. J Clin Med 2024;13:2009. DOI: https://doi.org/10.3390/jcm13072009
3. Wolf PA, Abbott RD, Kannel WB. Atrial Fibrillation as an independent risk factor for stroke - The Framingham Study. Stroke 1991;22:983-8. DOI: https://doi.org/10.1161/01.STR.22.8.983
4. Hart RG, Pearce LA, Aguilar MI. Meta-analysis: Antithrombotic therapy to prevent stroke in patients who have nonvalvular atrial fibrillation. Ann Intern Med 2007;146: 857-67. DOI: https://doi.org/10.7326/0003-4819-146-12-200706190-00007
5. Benjamin EJ, Wolf PA, D'Agostino RB, et al. Impact of atrial fibrillation on the risk of death: the Framingham Heart Study. Circulation 1998;98:946-52. DOI: https://doi.org/10.1161/01.CIR.98.10.946
6. Kirchhof P, Benussi S, Kotecha D, et al. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Europace 2016;18:1609-78. DOI: https://doi.org/10.5603/KP.2016.0172
7. Wiggins BS, Cibotti-Sun M, Moore MM. 2023 Atrial fibrillation guideline-at-a-glance. J Am Coll Cardiol 2024;83:280-4. DOI: https://doi.org/10.1016/j.jacc.2023.10.021
8. Joglar JA, Chung MK, Armbruster AL, et al. 2023 ACC/AHA/ACCP/HRS guideline for the diagnosis and management of atrial fibrillation: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol 2024;83:109-279. DOI: https://doi.org/10.1016/j.jacc.2023.08.017
9. Alenghat FJ, Alexander JT, Upadhyay GA. Management of atrial fibrillation. JAMA 2024;332:1936-7. DOI: https://doi.org/10.1001/jama.2024.19565
10. Carnicelli AP, Hong H, Connolly SJ, et al. Direct oral anticoagulants versus warfarin in patients with atrial fibrillation: patient-level network meta-analyses of randomized clinical trials with interaction testing by age and sex. Circulation 2022;145:242-55. DOI: https://doi.org/10.1161/CIR.0000000000001058
11. Eikelboom JW, Connolly SJ, Brueckmann M, et al. Dabigatran versus warfarin in patients with mechanical heart valves. N Engl J Med 2013;369:1206-14. DOI: https://doi.org/10.1056/NEJMoa1300615
12. Connolly SJ, Karthikeyan G, Ntsekhe M, et al. Rivaroxaban in rheumatic heart disease- associated atrial fibrillation. N Engl J Med 2022;387:978-88. DOI: https://doi.org/10.1056/NEJMc2213437
13. Wang TY, Svensson LG, Wen J, et al. Apixaban or warfarin in patients with an On-X mechanical aortic valve. NEJM Evid 2023;2:EVIDoa2300067. DOI: https://doi.org/10.1056/EVIDoa2300067
14. Andrade JG, Deyell MW, Macle L, et al. Progression of atrial fibrillation after cryoablation or drug therapy. N Engl J Med 2023;388:105-16. DOI: https://doi.org/10.1056/NEJMoa2212540
15. Osmancik P, Herman D, Neuzil P, et al. Left atrial appendage closure versus direct oral anticoagulants in high-risk patients with atrial fibrillation. J Am Coll Cardiol 2020;75:3122-35. DOI: https://doi.org/10.1016/j.jacc.2020.04.067
16. Lopes RD, Heizer G, Aronson R, et al. Antithrombotic therapy after acute coronary syndrome or PCI in atrial fibrillation. N Engl J Med 2019;380:1509-24. DOI: https://doi.org/10.1056/NEJMoa1817083
17. Cho MS, Kang DY, Ahn JM, et al. Edoxaban antithrombotic therapy for atrial fibrillation and stable coronary artery disease. N Engl J Med 2024;391:2075-86. DOI: https://doi.org/10.1056/NEJMoa2407362
How to Cite
Management of atrial fibrillation: a practical and useful synopsis of last guidelines. (2025). Bleeding, Thrombosis and Vascular Biology, 4(1). https://doi.org/10.4081/btvb.2025.168
Copyright (c) 2025 The Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
